JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2017, Vol. 31 ›› Issue (3): 9-12.doi: 10.6040/j.issn.1673-3770.0.2017.184

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Long-term anti-inflammatory treatment of allergic rhinitis.

SHI Li,  ZHAO Li, ZHANG Hongping   

  1. Department of Otolaryngology Head and Neck Surgery, the Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2017-05-10 Online:2017-06-16 Published:2017-06-16

Abstract: In Symptom-free patients with allergies, a subclinical inflammatory state has been described, in which subthreshold doses of an allergen have been found to cause inflammatory cell infiltration into the nasal mucosa. This includes increases in the levels of cellular adhesion molecules, nasal and conjunctival eosinophilia, and other markers of inflammation, which do not result in overt allergic symptoms. While allergic rhinitis(AR)treatment is typically guided by the need to reduce symptoms, the treatment strategies that reduce inflammation during asymptomatic periods may have positive effects on the onset, progression, and severity of AR. Therefore, treatment options that target underlying inflammation along with symptom relief should be considered. There are three major classes of commonly used AR medications, namely, intranasal corticosteroids, antihistamines, and antileukotrienes. Among these, intranasal corticosteroids appear to be the most reasonable therapeutic option in patients who would benefit from continuous inhibition of persistent inflammation.

Key words: Allergic rhinitis, Glucocorticoids, Inflammation, Anti-allergic agents, Drug therapy

CLC Number: 

  • R765.21
[1] Bousquet J, Schunemann HJ, Samolinski B, et al. Allergic Rhinitis and its Impact on Asthma(ARIA): achievements in 10 years and future needs[J]. J Allergy Clin Immunol, 2012, 130(5):1049-1062.
[2] Brozek JL, Baena-Cagnani CE, Bonini S, et al. Methodology for development of the Allergic Rhinitis and its Impact on Asthma guideline 2008 update[J]. Allergy, 2008, 63(1):38-46.
[3] Assing K, Bodtger U, Poulsen LK, et al. Grass pollen symptoms interfere with the recollection of birch pollen symptoms-a prospective study of suspected, asymptomatic skin sensitization[J]. Allergy, 2007, 62(4):373-377.
[4] Montoro J, Sastre J, Jauregui I, et al. Allergic rhinitis: continuous or on demand antihistamine therapy?[J]. J Invest Allergy Clin Immunol, 2007,17(Suppl 2):21-27.
[5] Pitsios C, Papadopoulos D, Kompoti E, et al. Efficacy and safety of mometasonefuroatevsnedocromil sodium as prophylactic treatment for moderate/severe seasonal allergic rhinitis[J]. Ann Allergy Asthma Immunol, 2006, 96(5):673-678.
[6] Ricca V, Landi M, Ferrero P, et al. Minimal persistent inflammation is also present in patients with seasonal allergic rhinitis[J]. J Allergy Clin Immunol, 2000, 105(1 Pt 1):54-57.
[7] Salmun LM. Antihistamines in late-phase clinical development for allergic disease[J]. Expert Opin Invest Drugs, 2002, 11(2):259-273.
[8] Canonica GW, Tarantini F, Compalati E, et al. Efficacy of desloratadine in the treatment of allergic rhinitis: a meta-analysis of randomized, double-blind, controlled trials[J]. Allergy, 2007, 62(4):359-366.
[9] Pasquali M, Baiardini I, Rogkakou A, et al. Levocetirizine in persistent allergic rhinitis and asthma: effects on symptoms, quality of life and inflammatory parameters[J]. Clin Exp Allergy, 2006, 36(9):1161-1167.
[10] Lauriello M, Muzi P, Di Rienzo L, et al. A two-year course of specific immunotherapy or of continuous antihistamine treatment reverse eosinophilic inflammation in severe persistent allergic rhinitis[J]. Acta Otorhinolaryngol Ital, 2005, 25(5):284-291.
[11] Dizdar EA, Sekerel BE, Keskin O, et al. The effect of regular versus on-demand desloratadine treatment in children with allergic rhinitis[J]. Int J Pediatr Otorhinolaryngol, 2007, 71(6):843-849.
[12] Canonica GW, Fumagalli F, Guerra L, et al. Levocetirizine in persistent allergic rhinitis: continuous or on-demand use? A pilot study[J]. Curr Med Res Opin, 2008, 24(10):2829-2839.
[13] Price D, Bond C, Bouchard J, et al. International Primary Care Respiratory Group(IPCRG)Guidelines: management of allergic rhinitis[J]. Prim Care Respir J, 2006, 15(1):58-70.
[14] von Moltke J, Trinidad NJ, Moayeri M, et al. Rapid induction of inflammatory lipid mediators by the inflammasome in vivo[J]. Nature, 2012, 490(7418):107-111.
[15] Montoro J, Del Cuvillo A, Mullol J, et al. Validation of the modified allergic rhinitis and its impact on asthma(ARIA)severity classification in allergic rhinitis children: the PEDRIAL study[J]. Allergy, 2012, 67(11):1437-1442.
[16] Xu Y, Zhang J, Wang J. The efficacy and safety of selective H1-antihistamine versus leukotriene receptor antagonist for seasonal allergic rhinitis: a meta-analysis[J]. PLoS One, 2014, 9(11):e112815.
[17] Ciprandi G, Frati F, Marcucci F, et al. Nasal cytokine modulation by montelukast in allergic children: a pilot study[J]. Eur Ann Allergy Clin Immunol, 2003, 35(8):295-299.
[18] Wei C. The efficacy and safety of H1-antihistamine versus Montelukast for allergic rhinitis: A systematic review and meta-analysis[J]. Biomed Pharmacother, 2016, 83:989-997.
[19] Erdogan BA, Sanli A, Paksoy M, et al. Quality of life in patients with persistent allergic rhinitis treated with desloratadinemonotherapy or desloratadine plus montelucast combination[J]. Kulak Burun Bogaz Ihtis Derg, 2014, 24(4):217-224.
[20] Yilmaz O, Altintas D, Rondon C, et al. Effectiveness of montelukast in pediatric patients with allergic rhinitis[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(12):1922-1924.
[21] Mygind N, Nielsen LP, Hoffmann HJ, et al. Mode of action of intranasal corticosteroids[J]. J Allergy Clin Immunol, 2001, 108(Suppl 1):S16-25.
[22] Yanez A, Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis[J]. Ann Allergy Asthma Immunol, 2002, 89(5):479-484.
[23] Ciprandi G, Tosca MA, Passalacqua G, et al. Intranasal mometasonefuroate reduces late-phase inflammation after allergen challenge[J]. Ann Allergy Asthma Immunol, 2001, 86(4):433-438.
[24] Baroody FM, Shenaq D, DeTineo M, et al. Fluticasone furoate nasal spray reduces the nasal-ocular reflex: a mechanism for the efficacy of topical steroids in controlling allergic eye symptoms[J]. J Allergy Clin Immunol, 2009, 123(6):1342-1348.
[25] Martin BG, Ratner PH, Hampel FC, et al. Optimal dose selection of fluticasone furoate nasal spray for the treatment of seasonal allergic rhinitis in adults and adolescents[J]. Allergy Asthma Proc, 2007, 28(2):216-225.
[26] Corren J, Manning BE, Thompson SF, et al. Rhinitis therapy and the prevention of hospital care for asthma: a case-control study[J]. J Allergy Clin Immunol, 2004, 113(3):415-419.
[27] Graft D, Aaronson D, Chervinsky P, et al. A placebo- and active-controlled randomized trial of prophylactic treatment of seasonal allergic rhinitis with mometasonefuroate aqueous nasal spray[J]. J Allergy Clin Immunol, 1996, 98(4):724-731.
[28] Canonica GW, Compalati E. Minimal persistent inflammation in allergic rhinitis: implications for current treatment strategies[J]. Clin Exp Immunol, 2009, 158(3):260-271.
[29] Berger WE, Meltzer EO. Intranasal spray medications for maintenance therapy of allergic rhinitis[J]. Am J Rhinol Allergy, 2015, 29(4):273-282.
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